游离胫前动脉穿支皮瓣修复小腿软组织缺损的临床应用  

Clinical Application of Free Anterior Tibial Artery Perforator Flap for Repairing Soft Tissue Defect of Calf

作　　者：张靖嫔 罗锦辉[2] Zhang Jingpin(Huizhou Health Vocational and Technical College,Huizhou Guangdong 516000)

机构地区：[1]惠州卫生职业技术学院 [2]惠州市中心人民医院手足外科,广东惠州516000

出　　处：《黑龙江医药》2022年第3期527-530,共4页Heilongjiang Medicine journal

基　　金：惠州市科技计划项目(课题编号:20200402)。

摘　　要：目的:探究游离胫前动脉穿支皮瓣修复小腿软组织缺损的临床应用效果。方法:选取惠州市中心人民医院在2020年3月至2021年1月期间收治的小腿软组织缺损患者60例作为本次研究对象,按随机数字表法将以上小腿软组织缺损患者分为对照组(n=30)和研究组(n=30)。对照组应用小腿腓肠肌神经进行皮瓣修复;研究组采取游离胫前动脉穿支皮瓣修复术。对比两组患者皮瓣修复术后并发症及外观形态情况;采用我院自行设计的满意调查问卷进行调查,对比两组患者术后恢复对皮瓣外形的满意程度。结果:60例患者在行皮瓣修复术后,部分患者皮瓣因血肿或静脉回流引发皮瓣肿胀及部分坏死,但经药物治疗后均完全愈合。对照组出现血肿、回流障碍及坏死的并发症共4例(13.33%),研究组患者出现血肿、回流障碍及坏死的并发症共3例(10.00%),两组患者并发症情况相比差异较小(χ^(2)=0.172,P=0.683);对照组对皮瓣外形满意程度为83.33%,而研究组患者的满意度为100.00%,显然研究组患者总满意度高于对照组患者(P<0.05)。结论:对小腿软组织缺损患者应用游离胫前动脉穿支皮瓣修复术,可有效改善患者皮瓣外形状态,利于提高患者的修复满意度,值得临床推荐。Objective:To investigate the clinical effect of free anterior tibial artery perforator flap in repairing soft tissue defect of calf.Methods:A total of 60 patients with soft tissue defects of the lower leg admitted to Huizhou Central People's Hospital from March 2020 to January 2021 were selected as the subjects of this study.According to the random number table method,the patients with soft tissue defects of the lower leg were divided into control group(n=30)and study group(n=30).In the control group,calf gastrocnemius nerve flap was used for repair.The study group used free anterior tibial artery perforator flap repair.The postoperative complications and appearance of skin flap were compared between the two groups.The satisfaction questionnaire designed by our hospital was used to investigate and compare the satisfaction degree of the two groups of patients with the appearance of the flap after postoperative recovery.Results:After skin flap repair in 60 patients,some skin flaps were swollen and partially necrotic due to hematoma or venous reflux,but all healed completely after drug treatment.There were 4 patients(13.33%)in the control group and 3 patients(10.00%)in the study group with hematoma,obstruction of reflux and necrosis.There was no significant difference in complications between the two groups(χ^(2)=0.172,P=0.683).The satisfaction degree of skin flap appearance in the control group was 83.33%,while that in the study group was 100.00%,indicating that the total satisfaction degree in the study group was higher than that in the control group(P<0.05).Conclusion:The application of free anterior tibial artery perforator flap for the repair of the soft tissue defect of the calf can effectively improve the appearance of the flap,which is beneficial to improve the repair satisfaction of the patients,and is worthy of clinical recommendation.

关 键 词：小腿软组织缺损 胫前动脉 皮瓣修复术 外科皮瓣 应用效果 

分 类 号：R658.3[医药卫生—外科学]